Umbilical Hernia Surgery

Since an Umbilical hernia will not get better or go away on its own, it is often recommended to have surgery.

The watch and wait approach may only be recommended if the hernia is very small and not causing any symptoms. If it is enlarging or uncomfortable or painful, repair should be considered.

An umbilical hernia is the easiest of all hernias to diagnose. A visible bulge in the umbilicus is usually very obvious to the patient and their doctor. One can also often feel the hernia defect under the umbilicus with deep palpation by an experienced examiner. Sometimes hernias are found on CT scan or MRI when there is a defect in the midline fascia between the rectus muscles.

Umbilical hernia repair pushes the contents of the hernia back into place and closes the abdominal wall defect through various surgical options.

Umbilical hernia repair is typically one of the simplest and safest operations among all hernia procedures. It is an operation that takes less than one hour and can be performed outpatient in a hospital or surgery center. It is usually performed under general anesthesia. It can be performed with conventional open techniques or with the latest robotic technology.

Dr. Yunis offers a variety of hernia repair techniques based on the type of hernia and to suit his patients' needs. Techniques available for Umbilical hernia repair include:

This type of hernia surgery involves making a small cosmetically oriented incision near the hernia and sewing the hernia defect closed. Dr Yunis has a bias to avoid the use of mesh in small umbilical hernias.

The conventional open technique is the most common and appropriate technique for typical small umbilical hernias. It involves a small incision around the umbilicus (belly button). The incision is made as small as possible with an emphasis on an optimal cosmetic outcome. The hernia is exposed with delicate and meticulous technique. After complete exposure of the hernia defect and reduction of the hernia contents, the hernia is repaired with a sewing technique without the use of mesh and in some cases mesh is used to help prevent the risk of hernia recurrence. The use of mesh in umbilical hernias remains a topic of great controversy among hernia specialists. After repair of the hernia defect, the subcutaneous tissue and skin is reconstructed with a strong emphasis on optimal cosmetic outcome.

This is often used for larger umbilical hernias. It involves the use of the DaVinci robot through 3 small (half inch) incisions in the side of the abdomen.

The robotic repair is a minimally invasive technique appropriate for larger umbilical hernias. This involves general anesthesia and three half inch incisions on the right or left side of the abdomen. An ultra high definition 3d camera is inserted through one of the incisions and different instruments (scissor, clamps, or sewing needle holders) are inserted through the other two incisions. The camera and the instruments are attached to a robotic arm system. The surgeon controls everything while sitting in a console with a 3D viewer and sophisticated hand controls and multiple foot pedals. Ultimately the hernia is well exposed and sewn closed and usually a mesh is sewn below the area to reinforce the repair. The technology allows for unsurpassed vision and delicacy in the repair that yields a less painful result than laparoscopic surgery from the recent past.

Laparoscopic Repair involves the use of mesh or sutures being placed behind the hernia through small incisions in the side of the abdomen.

After umbilical hernia repair, the amount of pain is quite variable. If it is painful, it rarely persists for greater than 48 hrs. Typically, one can drive in 2-3 days after this operation and return to office work within 3-5 days. Those returning to heavy physical work or exercise whould discuss with their surgeon what limitations they should have and for how long.

Umbilical hernia repair is potentially the safest and simplest of all hernia repairs. Despite the potential simplicity of an umbilical hernia repair, complications are not uncommon. The most feared complication of umbilical hernia repair is mesh infection. When mesh becomes infected after umbilical hernia repair, typically 2 or more subsequent operations will be required to solve the problem. First the infected mesh will require removal, which can itself be technically demanding. When removing the mesh, the hernia repair at that time typically has a high risk of recurrence. A third and more significant operation is required to repair this residual recurrent hernia because after mesh removal, the hernia defect usually becomes larger and more complicated.

If the initial umbilical hernia is small enough, there may be an option for a natural tissue repair without the use of mesh. A natural tissue repair has no chance of a mesh related infection.

An experienced hernia specialist may be your best option for umbilical hernia repair if you want to lower your risk of complications.

No- most umbilical hernias are not considered major surgery and patients go home the same day.

Many people can live with a hernia for their whole lives. Many choose to have their umbilical hernia repaired due to discomfort or pain, enlargement, or to eliminate the risk of emergency incarceration and strangulation.

No. Umbilical hernia repair is uniformly an outpatient operation.

It can be performed in a hospital or a surgery center.

If possible, optimize weight to achieve close to ideal body weight.

If one’s weight is significantly more than ideal, it is often beneficial to lose weight prior to umbilical hernia repair.

An umbilical hernia is a defect in the muscular abdominal wall in the area of the umbilicus where we were once connected to our mothers while in utero. There are many different ways to repair inguinal hernias (open, robotic, with mesh or no mesh). Most umbilical hernia repairs are outpatient procedures accociated with pain or discomfort that rarely is significant for more than 2-3 days. Most people can tolerated their postoperative pain with over the counter pain medications.

There are many options for repair of an umbilical hernia including conventional open surgery, laparoscopic, or robotic surgery. Hernia experts continue to discuss the comparison of the results from these techniques. The surgeons expertise and available technology will often dictate which is best for each patient.

If a patient develops severe pain that is unrelenting, the emergency room is the best option to diagnose and treat.

There are many different surgical options available for umbilical hernia surgery. Typically the risk of complications is less than 1% and the risk of hernia recurrence is under 10%.